Association of complicated gallstone disease in pregnancy and adverse birth outcomes

Am J Surg. 2020 Sep;220(3):745-750. doi: 10.1016/j.amjsurg.2020.01.038. Epub 2020 Jan 24.

Abstract

Background: Complicated gallstone disease (CGD) is a common condition requiring intervention during pregnancy to avert adverse birth outcomes (ABO).

Methods: Cohort study using the California OSHPD 2007-2014 database. Records of pregnant patients were analyzed for gallbladder calculus within four months of delivery. Biliary system interventions were evaluated as the primary exposure.

Results: Of 7,597 patients, those with CGD had a greater likelihood of biliary system procedures than those with uncomplicated gallstone disease (36.6% vs. 2.5%, p < 0.001). Patients with CGD also had increased odds of ABO (OR 2.02, 95% CI, 1.48-2.76). Compared to patients without biliary system procedures, those with interventions for gallstones had an OR of 3.46 (95% CI, 2.48-4.82) for ABO. After adjustment, biliary system intervention for CGD had an even greater risk of ABO (OR 4.26, 95% CI, 2.86-6.35).

Conclusions: The risk of ABO is significantly increased in women with CGD and intervention for gallstones.

Keywords: Adverse birth outcome; Gallstone disease; Pregnancy; Surgical intervention.

MeSH terms

  • Abortion, Induced / statistics & numerical data
  • Abortion, Spontaneous / epidemiology
  • Adult
  • Cohort Studies
  • Female
  • Fetal Death
  • Gallstones / complications*
  • Humans
  • Pregnancy
  • Pregnancy Complications* / epidemiology
  • Pregnancy Outcome*
  • Premature Birth / epidemiology
  • Risk Assessment
  • Young Adult